Individual
MRS. AMY JOSEPHINE BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
4100 JOHN R ST, DETROIT, MI 48201-2013
(800) 527-6266
Mailing address
1210 JUNCTION ST, PLYMOUTH, MI 48170-1134
(248) 229-2893
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704322193
MI
Other
Enumeration date
08/09/2020
Last updated
08/30/2023
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